Organization
LOUDERBACK DRUG OF MADISON INC
Active
Other names
LOUDERBACK DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT LOUDERBACK PHARM D (PRESIDENT)
(402) 454-2525
Entity
Organization
Contact information
Practice address
201 S MAIN ST, MADISON, NE 68748-6485
(402) 454-2525
(402) 454-2945
Mailing address
201 S MAIN ST, PO BOX 389, MADISON, NE 68748-6485
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2671
NE
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2055498
PK
—
05
—
4708556900
—
NE
Enumeration date
08/18/2006
Last updated
02/11/2020
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